The effect of chemosurgical peels and dermabrasion on dermal elastic tissue

Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alteration in dermal histology and mechanical properties of skin following treatment with 25% and 50% trichloroacetic acid, Baker's phenol solution, and dermabrasion. Yucatan minipigs served as the animal model. The skin was analyzed at five intervals over 6 months after treatment using histologic, quantitative, and mechanical analysis (hematoxylin and eosin, elastic tissue, and Sirius red stains, computerized digital morphometry, and a tensiometer). At 6 months we found no change in the quality, structure, or arrangement of elastic fibers in skin treated with a single application of 25% and 50% trichloroacetic acid or dermabrasion when compared with untreated skin. Skin treated with Baker's phenol solution showed a marked morphologic change in the elastic fibers. The fibers within the regenerated zone of dermis were sparse, wispy, and immature at 6 months after treatment. Preliminary tensiometric analysis of phenol-treated skin at 6 months indicated that the skin was stiffer and weaker. This study questions the possibility of long-term change to the skin by the deep penetration of caustic chemicals to remove wrinkles and rejuvenate the skin.